Provider Demographics
NPI:1467945022
Name:TORRES, CARMEN M (EDD)
Entity Type:Individual
Prefix:MS
First Name:CARMEN
Middle Name:M
Last Name:TORRES
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 FENWOOD RD APT 2
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-6101
Mailing Address - Country:US
Mailing Address - Phone:617-738-7179
Mailing Address - Fax:
Practice Address - Street 1:21 FENWOOD RD APT 2
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6101
Practice Address - Country:US
Practice Address - Phone:617-738-7179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-08
Last Update Date:2018-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4774-PY-PR103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling